The registered nurse is discussing care of an infant diagnosed with a patent ductus arteriosus (PDA) with a nursing student. The registered nurse determines that the nursing student needs further teaching regarding a PDA when the student states that which circulatory change is a characteristic of this disorder?

A. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling.
Explanation: Elevating the extremity can help reduce swelling, especially in the initial period after casting.
B. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold.
Explanation: Applying heat can increase the risk of burns and is not recommended. If the fingers feel cold, it may indicate a circulation issue, and the healthcare provider should be contacted.
C. Keep small toys and sharp objects away from the cast.
Explanation: Keeping small toys and sharp objects away from the cast is important to prevent injury or damage to the cast.
D. Use a padded ruler or another padded object to scratch the skin under the cast if it itches.
Explanation: Inserting objects under the cast can lead to complications, including skin damage or infection. It is advisable not to insert anything into the cast.
E. Use the fingertips to lift the cast while it is drying.
Explanation: Lifting or manipulating the cast during the drying process can compromise its integrity and should be avoided. The cast needs to dry completely to provide proper support and immobilization.
F. Contact the primary health care provider (PHCP) if the child complains of numbness or tingling in the extremity.
Explanation: Numbness or tingling can indicate a circulation problem, and it is important to contact the healthcare provider for further assessment.

The Parkland formula is commonly used to calculate the fluid requirements for burn resuscitation. The formula is:

Fluid requirement (in mL)=TBSA×Weight (in kg)×Fluid volume (in mL/kg)

For burn patients, the recommended fluid volume is typically 4 mL/kg for each percent of TBSA burned.

Let's calculate the fluid requirement for the given case:

Fluid requirement=40%×22 lbs×4 mL/kg

First, convert the weight from pounds to kilograms:

Weight (in kg)= Weight (in lbs)/2.2

Weight (in kg)=22 lbs/2.2≈10 kg

Now, calculate the fluid requirement:

Fluid requirement=40% x 10 kg × 4 mL/kg

Fluid requirement=1600mL(totalfluidover24hours)

Fluid for the first 8 hours:

1600/2=800ml

Thus, the child will receive 800 mL of fluid in the first 8 hours after the burn injury.